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Marmalade Care Ltd

DEMENTIA WITH LEWY BODIES

DLB

Dementia with Lewy bodies is the second most common type of Dementia the first being Alzheimer's.

It is commonly mistaken for Alzheimer's.

It is named after a German man who discovered the Disease his name was 

Friedrich Heinrich Lewy 

….

Tiny deposits of protein build up in the nerve cells of the brain.

 researchers don't fully understand why  this happens but it is linked to low levels of acetylcholine and dopamine and a loss of connections between nerve cells that then die.

Dementia with Lewy body and Parkinson's  disease  are just two of several diseases which effect the brain and nervous system over time.

LB in the base of the brain is linked to movement this is the main feature of Parkinson's!

LB  in the outer layer of the brain is  linked to problems with mental abilities

 (cognitive symptoms) this is a feature of dementia with Lewy bodies .

A person with this diagnosis will have a progressive decline in  mental abilities the average life expectancy is from 6-12 years from diagnosi

.

EARLY SIGNS 

Tremors ,shaking fingers, thumb or chin 

Loss of smell

Trouble sleeping 

Dizziness ,fainting 

Constipation

Trouble moving or walking 

Low voice 

Masked face 

Not being able to stand properly 

…..

SYMPTOMS 

Shaking 

Tremors 

Hallucinations 

These are often people and animals

 The person will be convinced that what they are seeing is real and this can last for several minutes.

Hearing 

Knocking ,footsteps conversations that are not happening.

A common delusion is that someone is out to get them.

 Strangers living in the house they may think their husband, wife is an intruder.

This is extremely distressing for the carer.

Movement problems a bit like Parkinson's (slow and rigid)

Blank facial expression 

The person may Yell out 

Sleep disturbance

This is common and may start several years before being diagnosed

Incontinence 

 They may feel faint lose consciousness 


Later stages 

Aggression 

Restlessness

Yelling out 

Speech problems

Unable to walk properly leading to falls 

Problems with swallowing 

Chest infections 

Risk of choking 


Marina Barker 

For more information visit NHS helpline 







DEMENTIA IN THE MIRROR 

Whos that in the mirror that I see 

is it you it cant be me ,

for she is old and I am young 

The dance of Dementia has begun.

What is your name or should I know you say you knew me long ago.

Well long ago when I was me I had adventures by the sea ,

I was a a wife a friend a mother we used to chat to one another.

And now I sit here sipping tea with a wooly blanket on my knee.

My life is strange now I agree but sometimes I can still be me 

Don't talk about me when I'm near please understand I live in fear 

just hold my hand and speak to me now is it you it cant be me.

Marina Barker 

ATAXIA

This is a group of disorders that effect speech and is usually caused by damage to the cerebellum but can also be by damage to the spinal cord this is a long bundle of nerves that runs down the spine it connects the brain to all the different parts of your body.

causes can be due to trauma, vitamin deficiency, alcohol abuse, drugs, infections and cancers

there are several types of Ataxia 

Aquired Ataxia

Genetic Ataxia 

Idiopathic Ataxia


SYMPTOMS

slurring of speech 

frequent falls 

muscle tremors

vision problems 

heart problems 

slow eye movements 

difficulty with writing, eating 

wide based gate 

poor coordination of arms and legs 

balance and coordination will be affected first 


 HYPOTENSION 

Low Blood Pressure 

your blood pressure should be around 120/80mm

However it does fluctuate .

HYPOTENSION is when your blood pressure drops below 90/60mm

This can be caused by severe vomiting, Diarroea, sweating due to vigorous exercise .Problems with your heart because it cant pump the blood around your body ,Diseases such as Parkinson's , diabetes Age can also be a reason  and infections 

Symptoms 

Dizziness 

fainting 

Blurred vision 

feeling sick 

Palpitations 

unable to concentrate 

feeling thirsty

confusion

depression

feeling cold 

rapid shallow breathing 

fatigue 

sweating 

Shock can cause your blood pressure to drop however low blood pressure can also send you into shock in this case they will need to raise your blood pressure by IV fluids.

When your blood pressure drops quickly it can lead to shock

This is an emergency situation and you need medical help immediately

While you are waiting for medical help elevate the persons legs off the floor with whatever is available to you and keep them warm.

You will have tests to see what is causing your blood pressure and medication will no doubt be given.

You can help yourself by eating a well balanced diet 

avoiding alchohol

Drink plenty of water 2-3 litres a day 

eat more salt 

eat smaller portions several times a day helps your blood pressure from falling rapidly. 

Marina Barker 


 

SHADOWING

You may find that your loved one or the person you are caring for starts following you around constantly.

In the middle and later stages of the Dementia journey the person will start to feel a loss of who they are and be anxious about what is going on afraid of being left alone they are following you because they need to feel safe. they will ask you the same question every few minutes.

Try to reasure  them that they are safe try to move the focus by doing little jobs together dusting ,peeling vegetables even folding towels .

It is extremely frustrating being followed around by someone constantly so remember to breath deeply and when ever you can have ten minutes to yourself.

Cadisil

This stands for 

CEREBRAL  AUTOSOMAL DOMINANT ARTERIOPATHY  WITH SUBCORTICAL INFARCTS AND LEUKOENCEPHALOPATHY 

This is rare it is a type of vascular disease .This is a disease of the blood vessels as in arteries and veins 

 Cadisil is caused by a faulty gene When one  of your parents carries the gene  you have a 1 in 2 chance of developing Cadisil .


 when a person has Cadisil they are likely to have several mild strokes which cause damage to the brain tissue mostly the white matter that connects different parts of the brain.


SYMPTOMS 

migraines 

slurred speech 

weakness down one side of the body 

may effect memory 

visuospatial skills 

lack of motivation 

apathy 

anxiety 

depression \

At the moment there is no cure for Cadisil  some of the symptoms can be managed 

such as drugs for high blood pressure and cholesterol and making lifestyle changes.


Women may notice symptoms in pregnancy 

About 2 in 3 people will go on to develop Dementia 

More information is available on 

Alzheimers.ork.uk 

Marina Barker 




Vitamin B12 Deficiency

It is thought that this effects around 6 in every 100 people under 60 years old and 20 in every 100  people over 60 years old .

There are a lot of different symptoms 

Tingling and numbness in limbs

Lack of coordination 

Unsteadiness

Problems with vision 

When the problems are not treated it can come across very much like Dementia 

In some cases a limited diet of meat, eggs  and dairy for example in vegans and vegetarians may result in insufficient B12

In some cases the body is unable to absorb B12 this is due to certain genetic conditions such as pernicious anemia or from taking medication such as metformin.

If treated early enough the symptoms of vitamin B12 can be reversed through supplements, injections and changes in diet.

The help line for Pernicious Anemia is 01656 769717

Marina Barker 


POSTERIOR CORTICAL ATROPHY 

This is a rare form of Dementia that begins by affecting your vision it is also called Bensons syndrome 

It is caused by damage to the brain cells at the back of the brain .

The part that processes information from your eyes and makes sense of what you see.

Alzheimers disease is often the cause of brain cell damage in PCA but it can be caused by Dementia with Lewy bodies and in rare cases it can be caused by Corticobasal syndrome or Creutzfield-jacob disease.

Alzheimers disease normally affects your memory first PCA starts with your vision 

normally this would develop between the ages of 50-65 how many people it affects around the world is not known.

Symptoms of PCA

Things appear to have unusual  ,a client of mine complains that her brown walking stick is green and her hands are always turning red !

Objects are not recognisable and sometimes float around in front of you.

A puddle can look like a hole in the ground.

When you turn and walk away from an object you can sometimes still see it but then again you might not see things in front of you and walk straight in to them.

Trying to cross a road becomes problematic and not being able to recognise faces and object.

Can you imagine how stressful this must be.

Bright lights are often uncomfortable people with Dementia often sit in the dark with the curtains shut because they don't like the light.

Life expectancy with PCA is 8-12 years from diagnosis similar to Alzheimer's disease.

At the moment there are no specific treatments to stop or slow PCA but as with other types of dementia there are medicines to treat the symptoms they are called Cholinesterase inhibitors.

These medicines help the brain cells to communicate  with each other.

Im sure most of you who know someone with Dementia will recognise these names 

Donepezil

Rivastigmine

Galantamine

Memantine

These are the 4 Cholinesterase inhibitors

You can read up on PCA on Alzheimer's research uk 

Marina Barker


Vascular Dementia

Vascular Dementia is a common form of Dementia caused by a reduced blood flow to the brain a mini stroke where the blood supply to the brain is blocked off or lots of mini strokes these are called transient ischaemic or TIAs  attacks that cause widespread damage to the brain there is no cure for this as you cant replace the brain cells that have disappeared before the diagnosis but a medicines and a health life style may slow it down .

It is estimated there are 150.000 people affected in the UK.


SYMPTOMS

Difficulty making plans 

Problems with concentration 

Changes in behaviour 

Feeling disorientated and confused 

Difficulty walking and balance 

Though there is no cure eating a healthy diet 

Stopping smoking 

Cutting down on alcohol

Taking medicines such as those to treat blood clots, high blood pressure and lowe cholesterol can help 








DEMENTIA

THE BOOKCASE OF LIFE

Imagine you have a bookcase with several shelves

each shelf is packed with books and each book is a memory about your life it is about people you have met and places you have been memories happy or sad are in all these books.

the shelves are stages in your life starting at the bottom .

shelf number 1 bottom shelf

memories of when you were a child

shelf number 2

memories of your school ,college maybe even university.

shelf number 3

starting out in your chosen career.

shelf number 4

your first love ,getting married.

shelf number 5

having children.

shelf number 6

your children getting married and having children.

shelf number 7 top shelf

your retirement years .


Now imagine someone comes along and shakes the bookcase so hard that some of the books fall out .

Notice that more books fall out from the top shelves then they do from the bottom .

Not forgetting these books are your memories .


shelf number 7

the top shelf is almost empty

the shelf that holds your day today memories your memories of now !

so you cant remember who people are or where you are.

you are not familiar with your surroundings as you do not remember them .


shelf number 6

the shelf has a lot of books missing your memories of your children getting married of you becoming a grandparent .

so your not quite sure why they are there because who are they you do not know or remember them.


shelf number 5

you may have forgotten who your children are because the book of memories fell out of the bookcase .


shelf number 4

the book is missing from when you got married its gone it fell out ,the man in your house could be an intruder because you have no idea who he is.


shelf number 3

there a few books left here you clearly remember your days working at the bank and your achievements there and that you were there for 5 years .

but you don't know what you did after that because that book fell out .


Shelf number 2

there are books here and there on this shelf you can remember you went to college and that you studied accounts ,your school days and friends are still there but only sometimes because that book of memories is teetering on the edge of the shelf and is about to fall out.


shelf number 1

this shelf is almost full you remember your brothers and sisters and your parents and you spend all day wondering where they are and why there not looking for you


I REALLY HOPE THIS HELPS

MARINA 

  



SUNDOWNING 

Sundowning is also known as late-day confusion and is a form of Alzheimer's and other related forms of dementia .

Sundowning is not a disease but a group of symptoms effecting the person living with dementia.

This normally occurs late afternoon and carries on into the night .

the person will become confused and angry and it always seems to be as daylight fades and in the middle stages of dementia .

Some scientists believe that your body clock is affected by dementia and the part of your brain that recognizes when your asleep and when your awake breaks down.

These are a few things that might help

Avoid stimulant's

Alcohol

Coffee

Nicotine

Sweets and chocolate

Try to keep outings and appointments earlier in the day

Close the curtains and turn the lights out in the evening .

Make afternoons quite and calm .

Limit food intake in the evening to a snack rather than a hefty meal .


CHRONIC TRAUMATIC ENCEPHALOPATHY


Dementia pugilistica punch drunk syndrome

This is a neurodegenerative disease caused by repeated head injuries,

such as constant blows to the head and or repeated concussion .

this used to be called punch drunk syndrome or dementia pugilistica it is very common in boxers .

the disease usually begins several years after repeated blow to the head.

Symptoms

Changes in mood

Difficulty thinking (cognitive impairment )

Impulsive behavior

Short term memory loss

as the disease progresses ,slurred speech (dysarthria)

Significant memory loss

Parkinsonism symptoms

Difficulty swallowing (dysphagia)

there is no cure

This diagnosis will be treated with pain management and behavioral therapy to help with mood swings ,difficulty planning and carrying out tasks which will affect daily living as in personal care ,social interaction and general wellbeing.

The seven stages of Dementia 

no impairment 

everyone starts at stage 1 there are no symptoms of impairment and functions are normal

2  

very mild cognitive decline 

this can vary between age related problems that most seniors face such as forgetting things (dates,places ect.)

some of the signs of this stage 

forgetting everyday phrases

forgetting things like where you put your keys .

mild cognitive decline

this is where symptoms for dementia or Alzheimer's can be come more apparent  to family and friends 

it will not have a big impact on everyday life 

you may notice 

problems with complex tasks

memory loss, forgetfulness 

diminished work performance 

getting lost 

difficulty driving 

disorganization 

4

Moderate cognitive decline 

This is sometimes described as early onset Dementia or Alzheimer's

Symptons are more noticeable and the person concerned should be seeing a health professional

Symptoms may include 

Social withdrawal 

Moodiness

Non responsive   

Trouble with tasks

Denial 

Moderately severe cognitive decline 

The person concerned is now likely to need help with everyday tasks such as washing and dressing 

you may need a home carer 

Symptoms can include 

Confusion 

Forgetfulness

Memory loss i.e. personal details

Reduced mental ability for problem solving .

6

Severe cognitive decline 

Also known as middle stage Dementia or Alzheimer's 

The person concerned will now need help with daily activities such as using the bathroom or eating 

Symptoms may include 

Difficulty sleeping 

Increased paranoia 

Delusions 

Anxiety 

Difficulty recognizing loved ones 

7

Very severe cognitive decline 

 Described as late stage Dementia or Alzheimer's

The person concerned is now unable to care for themselves 

They may lose the power to walk or speak


-----------------------

 

 

SEMANTIC DEMENTIA 

 In the past it was believed that all dementia was the same this is not so only recently has it been that distinct disorders such as Semantic Dementia it is related to frontotemporal dementia it is a progressive loss of the ability to remember words ,faces and objects this is from the shrinkage of the temporal lobe in the brain.

the problem usually starts with words people will forget the names of things like calling milk water a dog a cat they may also have problems understanding what is said.

people also have difficulty recognizing faces of the people they see all the time

they will find it hard to recognize objects.

people might become self centered not bothering about other peoples feelings becoming preoccupied with certain activities having a fixed routine daily .

the person cannot change there behavior as it is due to the damage that is effecting there brain cells.

people will normally stay physically well but may become slower as the disease progresses.

this condition normally happens to people between 50 and 65 years of age .there is no cure but certain medication can help with the symptoms.


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                                                                                          WATER INTOXICATION

                                                                                  

                                                                                Also known as water poisoning

                                           This is a disruption to the brain caused by drinking to much water.

This is very rare and whilst it might be very difficult to consume to much water it does happen and death can occur due to                                                                                                       excessive intake of fluid .

Drinking to much water can increase the amount of water in the blood this can dilute the electrolytes, and especially sodium in                                                                                                         the blood.


          WHEN SODIUM FALLS BELOW 135 MILLMOLES PER LITRE DOCTORS REF TO IT AS HYPONATREMIA


This is very common in sports people or endurance training but it does occur in people with mental health issues .

On one occasion because an athlete was not properly rehydrated ,his sodium levels fell below130mm0l/1 he then developed

                                                       water on the brain this is known as hydrocephalus .

                                                    developed a hernia in his brain stem and this lead to his death .

Overhydration happens when someone drinks more than there kidneys can get rid of via urine .

A build up of fluid in the brain is called cerebral edema which can effect the brain stem leading to central nervous disfunction .

                                                               In severe cases this can lead to seizures ,brain damage and comas .

                                                                                                      

  SYMPTOMS

                                                                                            Confusion disorientation

                                                                                                            Nausea

                                                                                                         Vomiting

                                                                                                     double vision

                                                                                             difficulty breathing

                                                                                                muscle cramps

                                                                    not being able to identify sensory information

                                                    in rare circumstances swelling of the brain which can be fatal.